Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.766
Filtrar
1.
Indian J Ophthalmol ; 69(4): 985-986, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33727473

RESUMO

A 32-year-old man with a clear and compact graft following a penetrating keratoplasty 6 years back, developed an episode of acute graft rejection, coinciding with the COVID-19 disease. Subsequent to the infection with the novel coronavirus, he developed symptoms of acute graft rejection concurrent with the development of respiratory distress and peak systemic symptoms. This was the phase of cytokine storm as evidenced by the raised inflammatory markers in his blood tests. Such a case of acute corneal graft rejection coinciding with SARS-CoV-2 infection has been reported only once in the literature and this unique association needs to be researched further.


Assuntos
/diagnóstico , Doenças da Córnea/diagnóstico , Infecções Oculares Virais/diagnóstico , Rejeição de Enxerto/diagnóstico , Ceratoplastia Penetrante , Doença Aguda , Adulto , /virologia , Extração de Catarata , Doenças da Córnea/tratamento farmacológico , Doenças da Córnea/virologia , Citocinas/sangue , Infecções Oculares Virais/tratamento farmacológico , Infecções Oculares Virais/virologia , Glucocorticoides/uso terapêutico , Rejeição de Enxerto/tratamento farmacológico , Rejeição de Enxerto/virologia , Humanos , Incidência , Mediadores da Inflamação/sangue , Implante de Lente Intraocular , Masculino , Pneumonia Viral/sangue , Prednisolona/uso terapêutico , Acuidade Visual
2.
Vestn Oftalmol ; 137(1): 78-82, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33610154

RESUMO

Persistent corneal graft erosion or persistent epithelial corneal defect is a frequent complication of penetrating keratoplasty. Its development can be contributed by the dry eye syndrome, rare blinking, lagophthalmos, symblepharon, viral infection, autoimmune aggression, and the use of epithelial-toxic eye drops. The article presents three clinical observations of patients who developed persistent corneal graft erosion after penetrating keratoplasty. Due to the ineffectiveness of local conservative therapy for more than 3 weeks, anterior stromal corneal micropuncture was performed. After the procedure, there was a gradual epithelial proliferation, complete healing of the corneal surface was observed 10-16 days after the manipulation, the follow-up period was at least 1 year. The mechanism of action of stromal micropuncture is associated with the creation of a porous surface with better adhesion properties, as well as with the activation of the production of extracellular matrix glycoproteins such as fibronectin, type IV collagen and laminin, which are necessary for stable adhesion of the epithelium. The use of stromal micropuncture of the donor flap in the treatment of post-keratoplasty persistent corneal epithelial defect was proposed for the first time.


Assuntos
Doenças da Córnea , Transplante de Córnea , Doenças da Córnea/diagnóstico , Doenças da Córnea/etiologia , Doenças da Córnea/cirurgia , Humanos , Ceratoplastia Penetrante/efeitos adversos , Soluções Oftálmicas , Punções
3.
Cornea ; 40(1): 123-124, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32889957

RESUMO

PURPOSE: To report a case of acute corneal endothelial graft rejection with the concurrent onset of coronavirus disease 2019 (COVID-19) symptoms. METHODS: Case report. RESULTS: A 31-year-old African American woman with a history of asthma, sleep apnea, obesity (body mass index of 40), and bilateral keratoconus was noted to have acute corneal endothelial graft rejection 3 months after uncomplicated penetrating keratoplasty of the left eye. The patient developed dysgeusia and subjective fever on the same day as ocular discomfort, and she was subsequently diagnosed with COVID-19 with only these 2 classic symptoms of the viral infection. CONCLUSIONS: Severe acute respiratory syndrome coronavirus 2 is known to cause conjunctivitis and has demonstrated transmissibility through ocular secretions. Acute immune and inflammatory dysregulations have been seen in cases of COVID-19 through various mechanisms. COVID-19 infection may potentially compromise ocular immune privilege contributing to acute corneal graft rejection.


Assuntos
/diagnóstico , Epitélio Posterior/patologia , Rejeição de Enxerto/diagnóstico , Ceratocone/cirurgia , Ceratoplastia Penetrante , Doença Aguda , Adulto , Disgeusia/diagnóstico , Feminino , Rejeição de Enxerto/etiologia , Humanos , Reação em Cadeia da Polimerase , Reoperação , Acuidade Visual/fisiologia
8.
9.
Medicine (Baltimore) ; 99(40): e21892, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019387

RESUMO

The aim of this study was to investigate the histopathological manifestations of congenital corneal staphyloma accompanied by anterior segment dysgenesis and evaluate the prognosis after penetrating keratoplasty with an ultralarge button graft.We retrospectively studied 8 pediatric patients with large congenital corneal staphylomas in the Department of Ophthalmology of Peking University Third Hospital, China, between September 2014 and December 2018. All patients underwent penetrating keratoplasty with ultralarge button grafts, as well as additional operations according to the abnormality of each eye. Pathological investigations of all samples obtained during penetrating keratoplasty were performed with hematoxylin and eosin staining.The main clinical characteristic of congenital corneal staphyloma was an extremely opaque and ectatic cornea. Histopathological examination showed abnormal corneal epithelia and stroma and an absence of Bowman membrane, Descemet membrane, and the endothelium. Different severities of anterior segment dysgenesis, presenting as various histopathological manifestations, were observed in all cases. Several postoperative complications occurred after penetrating keratoplasty in some of the patients; however, the complications were discovered and treated accordingly in a timely manner. Six patients achieved good visual outcomes and a satisfactory cosmetic appearance after penetrating keratoplasty. One patient eventually lost the transparency of the button because of corneal neovascularization, and 1 patient lost visual function because of retinal detachment.Congenital corneal staphyloma combined with anterior segment dysgenesis can exhibit various manifestations on histopathological examination. Penetrating keratoplasty with an ultralarge button graft seems to be a suitable treatment for congenital corneal staphyloma to obtain good functional and aesthetic prognoses.


Assuntos
Doenças da Córnea/cirurgia , Anormalidades do Olho/cirurgia , Ceratoplastia Penetrante/métodos , Doenças da Córnea/complicações , Doenças da Córnea/congênito , Doenças da Córnea/patologia , Anormalidades do Olho/complicações , Anormalidades do Olho/patologia , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos
10.
Cornea ; 39(12): 1599-1603, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32947412

RESUMO

PURPOSE: Corneal transplantation is the most frequently performed transplant procedure. In much of the world, the demand for donor tissue heavily outstrips supply. With developments within lamellar corneal graft surgery, the use of split corneal donor tissue to increase donor tissue supply seems a pragmatic solution to reduce the supply and demand mismatch. This is especially important with tissue supply expected to be affected by the COVID-19 pandemic. METHODS: A literature review of techniques was performed, enabling multiple transplants to be derived from a single donor and simulation of a model to quantify the number of corneas potentially saved. RESULTS: Studies on splitting corneal donor tissue have demonstrated that up to 5 recipients may benefit from 1 donor scleral button. The impact of splitting donor tissue may provide a saving of up to 25.3% of donor graft tissue. CONCLUSIONS: Splitting and preparing the donor tissue within an eye bank will improve tissue validation and donor tissue availability and may increase surgeon efficiency.


Assuntos
Betacoronavirus , Doenças da Córnea/cirurgia , Transplante de Córnea , Infecções por Coronavirus/epidemiologia , Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior , Bancos de Olhos/métodos , Ceratoplastia Penetrante , Pneumonia Viral/epidemiologia , Doadores de Tecidos , Humanos , Pandemias , Obtenção de Tecidos e Órgãos , Transplantados
11.
Vestn Oftalmol ; 136(4): 11-18, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32779452

RESUMO

PURPOSE: To analyze the effectiveness and safety of VEGF inhibitor used to improve keratoconus transplant survival in patients with corneal neovascularization as stand-alone and in combination with laser coagulation of ingrowing vessels before keratoplasty. MATERIAL AND METHODS: The study included 56 patients (56 eyes) with corneal opacifications of various etiology complicated by corneal neovascularization (CNV). The patients were divided into three groups. The 1st group included 27 patients with diffuse CNV who were undergoing an antiangiogenic therapy using anti-VEGF drug, the 2nd group - 14 patients with stem cell CNV who underwent laser coagulation of major corneal vessels combined with subconjunctival administration of drug before keratoplasty; the control group consisted of 15 patients with mixed type CNV who were undergoing conventional treatment without antiangiogenic therapy. RESULTS: During the follow-up (24.5±4.84 months, 4 to 25 months), transplant rejection reaction was recorded in 7 (23%) patients of the 1st group, 5 (35%) patients of the 2nd group and 9 (60%) patients of the control group. CONCLUSION: Subconjunctival administration of Aflibercept as a stand-alone measure and in combination with laser coagulation of ingrowing vessels may increase the chances of transparent transplant acceptance in high-risk keratoplasty.


Assuntos
Neovascularização da Córnea , Transplante de Córnea , Inibidores da Angiogênese/uso terapêutico , Bevacizumab/uso terapêutico , Humanos , Ceratoplastia Penetrante
12.
PLoS One ; 15(7): e0235233, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32628736

RESUMO

PURPOSE: To investigate the incidence of corneal transplantation and identify rates and risk factors of repeated corneal transplantation in South Korea. METHODS: This is a retrospective population-based cohort study using the Korean National Health Insurance System database. Among the entire South Korean population (N = 51,827,813), we included those who underwent corneal transplantation more than once between January 2006 and December 2016, and analyzed the annual incidence of keratoplasty. The person-year incidence of repeated keratoplasty after the first operation was calculated according to risk factors including age group, sex, income level, surgical method, surgical etiology, and presence of major systemic diseases. Cox regression analysis was employed to evaluate the hazard ratios of those risk factors on repeated keratoplasty. RESULTS: A total of 9,452 cases of corneal transplantation occurred from January 2006 to December 2016. The average annual incidence of corneal transplantations was 1.694 per 100,000. The proportion of penetrating keratoplasty steadily decreased from 92.22% in 2006 to 77.81% in 2016. The average incidence of repeated keratoplasty among those who underwent corneal transplantation at least once was 43.24 per 1,000 person-years. Males had a greater incidence of repeated keratoplasty compared to females (males: 47.66 per 1,000, females: 36.04 per 1,000). The age group from 20 to 39 years demonstrated the lowest incidence of repeated keratoplasty at 24.94 per 1,000. Keratoconus had the lowest incidence of repeated keratoplasty (22.82 per 1,000). CONCLUSION: This study may provide a better understanding of corneal diseases, help predict disease burden, and plan health care systems accordingly in South Korea.


Assuntos
Córnea/cirurgia , Transplante de Córnea/métodos , Ceratoplastia Penetrante/estatística & dados numéricos , Reoperação/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Transplante de Córnea/estatística & dados numéricos , Traumatismos Oculares/epidemiologia , Traumatismos Oculares/cirurgia , Feminino , Humanos , Incidência , Renda/estatística & dados numéricos , Ceratocone/epidemiologia , Ceratocone/cirurgia , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais
13.
Curr Opin Ophthalmol ; 31(4): 241-246, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32487809

RESUMO

PURPOSE OF REVIEW: Refractive surgery is one of the most popular elective procedures performed in the world. Given that dry eye is a common complaint following keratorefractive surgery, evaluation, and treatment of periocular conditions that further predispose the patient to dry eye symptoms is an important part of the presurgical assessment. Periocular conditions and surgeries can also affect the ocular surface and keratometry, and should be addressed. For example, ptosis, orbital fat herniation, ectropion, and eyelid masses have been shown to induce corneal topography changes and astigmatism. The oculoplastic considerations for refractive surgery include both the contribution of eyelid position on dry eye, ocular surface damage, refractive error, and outcomes, as well as the timing of oculoplastic surgery in relation to the refractive surgery. In this review, the recently published literature on eyelid and orbital surgery in relation to keratorefractive surgery is reviewed to elucidate the relationship of periocular factors with refractive surgery outcomes and complications. To improve keratorefractive surgery outcomes, a literature review is presented, discussing evaluation, management, and timing of management of oculoplastics conditions. RECENT FINDINGS: Dry eye syndrome is a well known complication of keratorefractive procedures. This is exacerbated with concurrent eyelid or orbital disorders, such as ectropion, lagophthalmos, and thyroid eye disease. In addition to impacting dry eye and ocular surface damage, eyelid surgeries can also affect corneal topography and refraction. Studies have found that patients with ptosis have topographic corneal aberrations from the eyelid exerting pressure on the cornea, while ptosis repair and blepharoplasty patients may undergo an astigmatic change postoperatively. Finally, the corneal flap created in laser-assisted in situ keratomileusis may be at risk for displacement or damage postoperatively with this risk changing, depending on method of flap creation, and time elapsed since keratorefractive surgery. SUMMARY: Eyelid and orbital conditions that predispose to dry eye syndrome and refractive changes should be evaluated and optimized prior to keratorefractive surgery. Patients electing to have oculoplastic surgery, like ptosis repair, should be fully healed prior to any refractive surgery to allow both refractive changes and eyelid positions to stabilize prior to the refractive surgery.


Assuntos
Blefaroptose/fisiopatologia , Síndromes do Olho Seco/fisiopatologia , Doenças Orbitárias/fisiopatologia , Erros de Refração/fisiopatologia , Procedimentos Cirúrgicos Refrativos , Astigmatismo/cirurgia , Blefaroptose/etiologia , Síndromes do Olho Seco/etiologia , Humanos , Ceratomileuse Assistida por Excimer Laser In Situ , Ceratoplastia Penetrante , Doenças Orbitárias/etiologia , Período Pós-Operatório , Refração Ocular/fisiologia
16.
Am J Ophthalmol ; 217: 232-239, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32437671

RESUMO

PURPOSE: To investigate the long-term stability of corneal astigmatism after combined femtosecond (fs)-assisted phacoemulsification and arcuate keratotomy. DESIGN: Retrospective, interventional case series. METHODS: Surgery was performed using a Victus (Bausch & Lomb) platform. A single, 450-µm-deep arcuate keratotomy was paired at the 8-mm zone with the main phacoemulsification incision in the opposite meridian. The keratotomy incisions were not opened. Corneal astigmatism measurements obtained preoperatively and at 2 and 5 years postoperatively were analyzed using vector analysis. RESULTS: A total of 44 eyes of 44 patients (mean age 66.0 ± 10.1 years) were included. The mean preoperative corneal astigmatism was 1.40 ± 0.66 diopters (D). This was reduced to 0.74 ± 0.54 D at 2 years and 0.70 ± 0.50 at 5 years postoperatively (P < .001). There were no statistically significant differences between postoperative corneal astigmatism at 2 years and at 5 years (P = .609). Both magnitude of error and absolute angle of error were comparable between the 2 postoperative time points (P > .805). At the end of 5 years, 65% of the eyes were within 15 degrees of the preoperative astigmatic meridian. Comparative analysis showed significantly higher surgically induced astigmatism, lower differences in vector and absolute angles of error for the eyes with preoperative with-the-rule (WTR) astigmatism than eyes with against-the-rule (ATR) astigmatism at 5 years (P < .004). CONCLUSIONS: Our study showed the stability of femtosecond (fs)-assisted arcuate keratotomy was well-maintained over 5 years. There was a tendency of increasing overcorrection of preoperative WTR astigmatism and undercorrection of ATR astigmatism over time.


Assuntos
Astigmatismo/etiologia , Córnea/cirurgia , Ceratoplastia Penetrante/efeitos adversos , Terapia a Laser/efeitos adversos , Facoemulsificação/efeitos adversos , Refração Ocular , Idoso , Astigmatismo/diagnóstico , Astigmatismo/fisiopatologia , Córnea/diagnóstico por imagem , Doenças da Córnea/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Facoemulsificação/métodos , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Acuidade Visual
18.
Zhonghua Yan Ke Za Zhi ; 56(4): 286-293, 2020 Apr 11.
Artigo em Chinês | MEDLINE | ID: mdl-32306621

RESUMO

Objective: To discuss clinical features and treatments of fungal keratitis, and to provide statistical data for clinical therapy and increase the therapeutic effects. Methods: This is a retrospective case series study. An analysis was performed by collecting patients' demography features, risk factors, onset time, lab results, clinical features and treatment from 1 414 cases of fungal keratitis from January 2006 to October 2016 in Qingdao Eye Hospital, Shandong Eye Institute. Results: In the 1 414 cases (1 414 patients), 1 174 patients (83.0%) came from different areas in Shandong Province, and the rest mainly from provinces on the north of Yangtze River. The age was 40 to 60 years in 874 cases (61.4%). The onset time was often in autumn and winter. The average duration between the onset and treatment was 1 to 74 days; 942 patients (67.1%) visited our hospital in 8-30 days after the appearance of the symptoms. Corneal trauma was the most common risk factor, especially injury by plants (367 cases, 26.4%). The positive rate of direct microscopic examination of potassium hydroxide wet mounts was 96.4%. The positive rate of confocal microscopy was 89.8%. Fungi were detected in corneal ulcer scrapings and (or) diseased corneal tissues obtained during surgery from 973 patients (68.8%). Most of the fungi were Fusarium (595 cases, 61.1%), followed by Alternaria (184 cases, 18.9%) and Aspergillus (119 cases, 12.2%). There were 603 cases (42.7%) of superficial and middle stromal infiltration, 614 cases (43.4%) of deep stromal infiltration and 197 cases (13.9%) of full-thickness corneal infiltration. Diameters of the corneal ulcer lesion were mostly between 4 and 6 mm (725 cases, 51.6%), followed by<3 mm (372 cases, 26.4%) and>6 mm (302 cases, 22.0%). Hypopyon was combined in 498 cases (35.2%), corneal perforation in 34 cases (2.4%), and endophthalmitis in 58 cases (4.1%). Surgery was performed in 1 198 cases (84.8%), including penetrating keratoplasty in 416 cases (29.4%), lamellar keratoplasty in 199 cases (14.1%), and corneal ulcer debridement in 532 cases (37.6%), with an effective rate of 98.1% (408 cases), 97.0% (193 cases) and 92.8% (494 cases), respectively. Two hundred and fifteen cases (15.2%) were treated with medical therapy alone, of which 147 cases (68.4%) were cured. Fifty-six patients (3.9%) finally lost their eye balls, including 54 cases of evisceration and 2 cases of ophthalmectomy. Conclusions: Fusarium is the main causative agent of fungal keratitis in Shandong Province. Direct microscopic examination of potassium hydroxide wet mounts is a simple, rapid and effective test method. Early diagnosis can be made if the result of corneal ulcer scraping examination is positive. Antifungal drug treatments can be done in early onset time. If the drug efficacy is poor or the patient's condition gets worse, immediate surgery is the key to controlling fungal keratitis. (Chin J Ophthalmol, 2020, 56:286-293).


Assuntos
Úlcera da Córnea/microbiologia , Infecções Oculares Fúngicas/diagnóstico , Infecções Oculares Fúngicas/terapia , Ceratite/microbiologia , Adulto , Antifúngicos/uso terapêutico , China , Fusarium/isolamento & purificação , Humanos , Ceratoplastia Penetrante , Pessoa de Meia-Idade , Estudos Retrospectivos
19.
Arq. bras. oftalmol ; 83(2): 98-102, Mar.-Apr. 2020. tab
Artigo em Inglês | LILACS | ID: biblio-1088974

RESUMO

ABSTRACT Purpose: To evaluate causes and management of congenital corneal opacities (CCO) diagnosed in a tertiary care eye center and to compare the data with a previous study at the same institution. Methods: Computerized medical records in all patients with congenital corneal opacities diagnosed in the Cornea Service at Wills Eye Hospital (Philadelphia, PA) between January 1, 2007, and December 31, 2015, were retrospectively reviewed. Children aged 12 years and younger at the first visit were included in the study. Patients' demographics, ocular diagnosis, laterality, associated ocular abnormalities, other ocular surgery performed prior or subsequent to the first visit, and their treatment were extracted from the medical records. Results: A total of 77 eyes in 56 patients were examined. The mean age at presentation was 32.8 ± 44.2 months, with the mean follow-up period of 26.7 ± 30.1 months. The most frequent diagnosis was Peters anomaly (53.2%), followed by limbal dermoid (13.0%), aniridia with glaucoma and microphthalmos (6.5%), sclerocornea and congenital glaucoma (5.2%), idiopathic (3.9%), Axenfeld-Rieger anomaly and Hurler syndrome (2.6%), and microcornea (1.3%). Primary keratoplasty was performed in 26 eyes, with the outcome rate in the clear cornea of 76.0% during the follow-up. Conclusion: Peters anomaly is the most common cause of congenital corneal opacities encountered at our institution. Penetrating keratoplasty is the most frequent choice of corneal surgery to treat congenital corneal opacities. Additional interventions during penetrating keratoplasty were moderately positively correlated with graft failure. This study also shows the rates of some etiologies of that changed over the recent decades in our tertiary care Cornea Service. Although Peters anomaly remains the most common presenting reason for congenital corneal opacities, its rate appears to be increasing over the recent decade. Congenital corneal opacities due to birth trauma, which is one of the preventable causes, were observed in a previous study in our clinic; however, no new cases were noted in this study.


RESUMO Objetivo: Avaliar as causas e o controle das opa cidades corneanas congênitas diagnosticadas em um centro oftal mológico de atendimento terciário e comparar os dados com um estudo anterior realizado na mesma instituição. Métodos: Prontuários médicos informatizados de todos os pacientes com opacidade corneana congênita diagnosticada no Serviço de Córnea no Wills Eye Hospital (Filadélfia, PA) entre 1º de ja neiro de 2007 e 31 de dezembro de 2015 foram revisados retrospectivamente. Crianças com 12 anos ou menos na primeira consulta foram incluídas no estudo. A demografia dos pacientes, o diagnóstico ocular, a lateralidade, as anormalidades oculares associadas, outras cirurgias oculares realizadas antes ou após a primeira consulta e o tratamento foram extraídos dos prontuários médicos. Resultados: Um total de 77 olhos de 56 pacientes foi examinado. A idade média de apresentação foi de 32,8 ± 44,2 meses, com um tempo médio de acompanhamento de 26,7 ± 30,1 meses. O diagnóstico mais frequente foi anomalia de Peters (53,2%), seguido por dermóide límbico (13,0%), aniridia com glaucoma e microftalmia (6,5%), esclerocórnea e glaucoma congênito (5,2%), idiopático (3,9%), síndrome de Axenfeld-Rieger e síndrome de Hurler (2,6%) e microcórnea (1,3%). Ceratoplastia primária foi realizada em 26 olhos, com desfecho de córnea clara de 76,0% durante o acompanhamento. Conclusão: A anomalia de Peters é a causa mais comum de opacidade corneana congênita encontrada em nossa instituição. A ceratoplastia penetrante é a escolha mais frequente de cirurgia corneana para o tratamento de opacidades corneanas congênitas. Intervenções adicionais durante a ceratoplastia penetrante foram moderadamente correlacionadas positivamente com a falha do enxerto. Este estudo também mostra as taxas de algumas etiologias do que mudou ao longo faz últimas décadas em nosso serviço de córnea de atendimento terciário. Embora a anomalia de Peters continue a ser a causa mais comum das opacidades congênitas da córnea, sua taxa parece estar aumentando na última década. Opacidades congênitas da córnea devido a trauma no nascimento, que é uma das causas evitáveis, foram observadas em um estudo anterior em nossa clínica; no entanto, nenhum caso novo foi observado neste estudo.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Opacidade da Córnea/cirurgia , Opacidade da Córnea/congênito , Centros de Atenção Terciária , Oftalmopatias Hereditárias/complicações , Anormalidades do Olho/complicações , Glaucoma/complicações , Registros Médicos , Estudos Retrospectivos , Fatores de Risco , Ceratoplastia Penetrante/métodos , Resultado do Tratamento , Estatísticas não Paramétricas , Córnea/anormalidades , Córnea/patologia , Doenças da Córnea/complicações , Opacidade da Córnea/complicações , Segmento Anterior do Olho/anormalidades
20.
Arq Bras Oftalmol ; 83(2): 98-102, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32159591

RESUMO

PURPOSE: To evaluate causes and management of congenital corneal opacities (CCO) diagnosed in a tertiary care eye center and to compare the data with a previous study at the same institution. METHODS: Computerized medical records in all patients with congenital corneal opacities diagnosed in the Cornea Service at Wills Eye Hospital (Philadelphia, PA) between January 1, 2007, and December 31, 2015, were retrospectively reviewed. Children aged 12 years and younger at the first visit were included in the study. Patients' demographics, ocular diagnosis, laterality, associated ocular abnormalities, other ocular surgery performed prior or subsequent to the first visit, and their treatment were extracted from the medical records. RESULTS: A total of 77 eyes in 56 patients were examined. The mean age at presentation was 32.8 ± 44.2 months, with the mean follow-up period of 26.7 ± 30.1 months. The most frequent diagnosis was Peters anomaly (53.2%), followed by limbal dermoid (13.0%), aniridia with glaucoma and microphthalmos (6.5%), sclerocornea and congenital glaucoma (5.2%), idiopathic (3.9%), Axenfeld-Rieger anomaly and Hurler syndrome (2.6%), and microcornea (1.3%). Primary keratoplasty was performed in 26 eyes, with the outcome rate in the clear cornea of 76.0% during the follow-up. CONCLUSION: Peters anomaly is the most common cause of congenital corneal opacities encountered at our institution. Penetrating keratoplasty is the most frequent choice of corneal surgery to treat congenital corneal opacities. Additional interventions during penetrating keratoplasty were moderately positively correlated with graft failure. This study also shows the rates of some etiologies of that changed over the recent decades in our tertiary care Cornea Service. Although Peters anomaly remains the most common presenting reason for congenital corneal opacities, its rate appears to be increasing over the recent decade. Congenital corneal opacities due to birth trauma, which is one of the preventable causes, were observed in a previous study in our clinic; however, no new cases were noted in this study.


Assuntos
Opacidade da Córnea/congênito , Opacidade da Córnea/cirurgia , Centros de Atenção Terciária , Segmento Anterior do Olho/anormalidades , Criança , Pré-Escolar , Córnea/anormalidades , Córnea/patologia , Doenças da Córnea/complicações , Opacidade da Córnea/complicações , Anormalidades do Olho/complicações , Oftalmopatias Hereditárias/complicações , Feminino , Glaucoma/complicações , Humanos , Lactente , Recém-Nascido , Ceratoplastia Penetrante/métodos , Masculino , Registros Médicos , Estudos Retrospectivos , Fatores de Risco , Estatísticas não Paramétricas , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...